First Two Weeks at Site

1 Aug

Monday July 18th was my first day of work at the health center. At the daily staff meeting I was asked to introduce myself along with a few other people who I think were interns. There were a lot of faces I didn’t remember seeing last time and some that I did. Again, they were amazed by the amount of Kinyarwanda I was able to speak. I said something along the lines of, “My name is Mahoro, I’m American, I’ll live and work here for two years. I’m trying to know Kinyarwanda. I have trouble when people speak quickly, sorry please speak slow.”

Monday I helped hand out ARVs with a woman I worked with during my site visit. Morning is the busiest time with people waiting for us when we show up after the staff meeting. After lunch there was a meeting with the community health workers and teachers to discuss the national vaccine campaign. Afterwards, I went back to the ARV office. Afternoons are slow going so I counting meds, exercised my limited Kinyarwanda and tried to read patient charts which are in French. Around 4:30 I smelled amandazi cooking so we went to see them cooking and then to eat some with tea. I ended up paying for mine and my coworkers’. Not really sure how that happened but what can you do? Side note, something that I’ve been struggling with is finding the line between Rwandan hospitality (I’ve been told people will take half of nothing and give it to you) and being taken advantage of. This very evening a coworker came by wanting food and like most other times, I just played it off. I feel a pang of regret every time though with the thought, “What if I’m being rude and burning bridges?” or “What if I’m in a place where I really need help/food/money will I be a sorry Charlie?” It doesn’t help that I’ve been trying to stretch my money because I didn’t want to leave my first weekend to go to the bank in Kamembe. That and I’ve been providing the bulk of the food for the woman I live with, and apparently the woman who has been making our meals. Back on track, last week was a national vaccine campaign week. In cooperation with community health workers and school staff, nurses from the health center went into various parts of the catchment area and schools to deworm kids and give them Vitamin A. The area around my health center is quite mountainous (understatement) and large so we operate two outposts . I spent Tuesday, Wednesday, and Thursday at the closer of the two, three kilometers north of the health center. The walk takes about an hour and I mostly downhill, which makes going home the more difficult of the two trips. It was absolutely amazing to look out across the mountains, see the health center tiny and faraway and to know that I walked the distance. There are two staff that work the outpost every day, one hands out meds and the other triages and does lab work. Another nurse and myself were the designated vaccine campaign people. Short of the time I chaperoned at a Foo Fighters concert, this was the least work like setting I’ve ever been in. We were at the top of a hill and on a mat under the shade of coffee plants is where we conducted the campaign. For the most part I did a whole lot of nothing. Between the CHWs and the nurse they had it covered. In the following days as I proved a bit of competence I was able to do some of the tracking paper work, and one day when I was left alone I ‘vaccinated’ five kids. When I think ‘vaccination’ my mind goes to needles and vaccine which is not what we were doing. The Vitamin A was in capsules that we broke the top off of and squirted in the mouth. The albendezole/mendezole was in tablet form. So for the older kids we just gave it to them to chew. For the younger ones we dissolved it in a spoon with some water and the drank it. Not sure on the success rate of this method because most of the time a lot of it ended up on their face/everywhere but their mouth. Or they were so upset that they ended up coughing/puking it up. I persevered with one boy when I dissolved a tablet after he puked up the tablet I gave him to chew. The CHWs visited the schools to vaccinate the kids there so we saw mostly kids younger than school age.

The outpost is close to the house of one of the CHW’s and she fed us every day we worked there, not sure if that’s standard practice or just because I was there. My coworker was hilariously sneaky about calling me when it was time to eat. The first day she told me we were going for a walk. The second day she said the CHW needed my help. Monday I lucked out and there was a vehicle working in the area who gave us a ride back to our general area. The rest of the days I made the trip to and from on foot. Tuesday was decently busy, Wednesday was reaaaaally slow, and Thursday I didn’t feel good. I was really tired and felt heavy limbed. I figured it was a combination of the days outside in the sun/heat and not drinking enough water so I made sure to drink plenty that afternoon. Between the water and food the walk home wasn’t so bad that day. There was a copy of Born To Run Floating around training and I started (re) reading it one day to pass the time so when I was walking on the goat paths to the outpost I was reminded of Born To Run and kept thinking how awesome it would be to run here. On the way back Wednesday I contemplated bringing running clothes the following day and running home. That was until I woke up exhausted the following morning.

Friday was my own personal hell. I worked at the health center helping with the administration of actual vaccinations with three other staff. My job was to weigh the babies and record it but before I did that I had to call the mother up. Sounds simple enough right? WRONG! Rwandans write in a script that is at best barely legible and Rwandan names have all the vowel combinations that I struggle to pronounce. So I’m shaking in my boots nervous trying to read chicken scratch and pronounce it right which makes it hard to remember the weights of the babes. I also had to ask how many months the kiddo had in order to plot it on the graph which was fine most of the time except when the mom would start mumbling something that even if I did know Kinyarwanda better would probably be difficult to understand.

As I weighed the babies I play a game, sweat vs pee because they are clammy from being strapped to mom’s back wrapped in several layers of towels/blankets and diapers are not prevalent in Rwanda. Even when there’s no mistaking the smell of urine I comfort myself with what has become my mantra after any less than hygienic toilet experience, “Urine is sterile and you’ve been vaccinated against Hepatitis.” Coupled with a reminder to keep my hands of my face and out of my incredibly itchy eyes I’m good to go! Disclaimer: I have my moments of ridiculous germaphoebia.

Adding to my stress were the random Kinya lessons from my coworker administering the vaccinations. He was fond of waving the needle around while he talked to me, and even though it was pre injection, visions of needle sticks danced through my head. Half the time he would just start talking not even bothering to see if I was listening or not. Then I saw some of the sticks he made and my blood pressure went up even higher. And always with the babies crying, which in of itself wasn’t that stressful but it was the straw that broke the camel’s back. After lunch, I walked through the health center and didn’t any staff I decided to head back home and spend some quality time with my Kinyarwanda grammar book.

Saturday I lazed around reading/journaling until 10 am whence I commenced cleaning. From 10 am to 4 pm I cleaned with a short break to eat lunch. I washed dishes, then clothes, ate lunch and then started wiping down the walls in the common area which are disgusting. I didn’t get too far before my arms got tired. Then I mopped, cleaned the shower and finally cleaned myself. I thought I’d treat myself to some biscuits and nutella so I went to buy some. Just as I was getting down to the business of snacking some guests showed up and ate all my biscuits 

Sunday there was a rumor that we were going to get electricity at our house. So between waiting for that, and the painful situation going on with my eyelids I skipped church and hung out/read all day. I don’t know if I managed to sun burn just my eyelids or if they were chapped but they hurt, and itched. They’re pretty much back to normal these days. This past week I worked in ARV on Monday, went for a loooooooong hike to another outpost on Tuesday. This one required the use of some pretty narrow paths as we descended the mountain behind the health center and into those beyond. We walked for an hour and a half before we reached our destination. My coworker was there to conduct ‘hygiene inspections’ so we visited some different shops and from what I could tell asked about some different practices like using sureau (bleach) in the water and cleaning. We were there for less than an hour before we headed back. Wednesday I worked with a coworker to give a nutritional supplement to some malnourished kids. There wasn’t a lot to do that day. Thursday I was back in ARV where I saw an albino. I’m not proud of the way I reacted, but after three months in Rwanda with limited time in Kigali around white people I’m really surprised whenever I see one. This person mystified me because at a distance they looked white but they spoke Kinyarwanda really well and were dressed like a farmer. It was evident they were an albino once I saw their eyes but I was still freaked out because I didn’t know if the blotches on their skin were carcinomas from advanced AIDS or intense sun exposure. Being around/near sick people still really freaks me out, especially here where the medical care at my health center is so rudimentary. Hopefully something that I’ll become less sensitive to over time.

Friday was a helluva adventure. I needed to go into Kamembe to do some banking. This was also the last day of the school term for three weeks so there was a mass exodus to Kamembe which combined with the rain that we had all that night and morning made for a kinda rough and expensive trip. Details about my awesome weekend in my weekend update post 😉

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4 Responses to “First Two Weeks at Site”

  1. Jamie Wulfekuhle August 3, 2011 at 6:23 am #

    Wow! Sounds like you have jumped right in!!! You are so brave! I hope you are being patient and gentle with yourself!

    Much love!

    • Heidi August 6, 2011 at 12:25 pm #

      Jamie, it’s questions like this that make me so thankful to have you as a friend. It’s a constant struggle, but I’m working to be mindful everyday of my needs.

  2. Travis August 5, 2011 at 6:46 am #

    H,
    two things:
    1) never give unless you want to. if you fee like they are taking advantages of you being a ‘bank’ then stop. set standards high and then drop them as you make legit friends. if you give and give now, then standard is set at that level and if/when you get frustrated and angry by always giving…they most likely wont understand. if you see people around you buying and sharing things with others, then go ahead; if you are the only one doing so and you find this to be un-needed, I suggest ceasing the act.
    2) I did the ‘baby weighing gig’ as one of my jobs in PC as well. The weighing cards and hand writing must be universal throughout Africa b/c I had the same issues, ha. Just remember to bring (and keep track of) your own good pens to write on the cards with and do what you can to correct the cards if they are incorrect; double-injections can harm the children, as you know
    much love from america, you’re doing great kiddo
    Travis W.

    • Heidi August 6, 2011 at 12:38 pm #

      Thanks Travis! I brought a supply of pens for me to use, and also to use as bribes/gifts because I heard the ones here stink. I feel really sorry for the education volunteers who have to grade student papers all the time.

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